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9 HARBOR VIEW TER - BUILDING INSPECTION (2) � , + � 1 �r{p�Sfi�Ef�L� A�PROYED 8Y �1E .IAISJ3E�JP� PFJIS�A 7P A PEAMIT B�G GRANTED � CITY OF SALEM ^ 3 v �..� ;, � oa�a . � -.33� No.�/�/-O!� �• !:' / �a�j'��. � � .. .�\�`,-.^�n � I,pC8t10II Of � � Is PropeAy Located in B,��g � fE/��°�K ✓/e`� the Historic District? Yes_NA J ��Ki24�� Is Property Loceted in Y��No_ -` the Conservetlon Area? BUILDING PERMIT APPLICATION FOR: Permit to: hed, Pool (Circle whichever apply) Roof, Reroof, Instatl Siding, Construct Deck, �/_J� RepaidReplace, Other.�%� ��^� ��'"�'�� '� PLEASE FlLL OUT LEGIBLY &COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: _ The undersigned hereby applies for a permit to build according to the following spec'rfications: Owners i��me i e�S�P�� 'J '� �2r{c P B7� 1 '7N'� v�53 Address & Phone 9 �/��� ���— — Architect's Name I` G . fZ C L L � Address & Phone 3�i7 �'s��Dt, �; �4LQ,^> N�i,_n_�k �r�� a �lS� Mechanics Name �( � �E�2i2ET��� ' 1 1 ' i �'.ws � �_� �7/a Add�ess & PhOne�� �/n0� L�C 5� -H ✓�' � � � ��'` . L�✓i�l S7 �e yy�t�g t�e ourpose ot buildl�g? ' . �Aetedel of building7 �ti� u u� II a dwelling, for how many famitles4 WIII bWlding coMortn to law7 Asbestos7 pV� c����� �m�U�x N °' �t � D��aS� Estlmated cost .—� (c�V " �L/ Ha�e 7mPro°sent � �• � `S � Signature of pplicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIP'TION OF WORK TO BE DONE I 3 � � p �,JC YP�.Sn / � U�— 1 � d 1 /�r�N �Tc�e� , d'�N�✓ATe �c7c ���1 MAIL PERMIT T0: � e s ��e ��y�J,��/''�A��P . �ff�"'—r �u � . _ , , �, � No. ��%� APPLICATION FOR PERMR TO (0+, 5 J�/�w<� �r ��'d-�� ,c�lLr�C�� LOCATION �J �J / � � ( / f"C��90 rL, e-n/ /G��,e PERMIT GRANTED � y��o�o� �� A AOV�D INSPEC _ R OF BUILDINGS � + ' f , CITY OR 3ALEM� MASSAC H lJ SE TTS PUBLIC PROPERTY DEPARTMENT 120 WASNINGTON STRL�. 9RD FIOOR SALfM, MASSACMUSETTS 01970 lTANL[Y J. U�py�CZ� JII, T[LFrMON[: 979-7qs_BSpS E7lT. 380 MAYOII FA%: 975-740-9646 - S8llnl BII��II4�pD�rtmanf DC�!'jd���-...8� F°0171d - U►accordance with the provisions of MGL c40 S 54, a condition of your Building Permit is that che debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: (Locadon of Facili ) rL-� s;�_P G �,J� , --- Signature of Applicant � Date i � ACOR_D_,,, CERTIFiCATE OF LIABILITY INSURANCE ( DATE(MMIODIYY'/Y) 04/03/2006 � aeooucee (g�8) 922-4600 THIS CERTIFICATE IS ISSUED AS A MATTEl2 OF INFORMATION ARCHER INSUF�ANCE ONLY AND CONFERS NO RIGHTS UPON"i -THE CERTIFICATE - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 271 CABOT ST ALTER THE COVERAGE AFFORDED BY THE ROLICIES BELOW. BEVERLY MA 01915- INSURERSAFFORDINGCOVERAGE ��NAIC# MSURED INSURER A:PENN—AMERICA Verrette, Ronald iNsuaeae:LIBERTY MUTUAL 16 Nor£olk Street iNsuReac: � wsuRER o� - " Haverhill MA 01630-310 wsuaEae COVERAGES � � THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE WSURED NAMED ABOVE FOR THE POLICY PERIOO INDICATED:NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAV BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IINSR AOD'L POUCY EFFECTIVE POLICY EXPIRATION LTR INSRO -TYPEOFINSURANCE POLICVNUMBER pATE(MMIOD/VY) OATE�MM/OO/VY) 1LIMITS A GENER4LLIABILITY PAC6464229 �2�22�2006 02�22�2007 EACHOGCURRENCE '�. $ 300�0�0 X COMMERCIALGENERqLLIABILITV OAMAGETORENTED � SO�OOO PREMISES Ea occurrence $ CLAIMS MADE � OCCUR � � � I '� ME�E%P(Any one persdn) $ S�OOO PERSONAL&ADV INJURY 8 3OO�OOO ' � � � � GENERALAGGREGATE $ 6OO�OOO GEN'LAGGREGATELIMITAPPLIESPER: �� PRODUCTS-COMP/OP.AGG $ 300�000 Poucv �Ec°r �oc / / / / AUTOM001LE LIABILITY � � � � ' COMBINEDSINGLELIM'T $ ANVAUTO ' (Eaaccitlenl) n��owNeonuros / / / / BO�ILYINJURY $ SCHEDULEOAUTOS (Perperson) . HIRE�AUTOS � � � � BODILYINJURV � �� NON-OWNEDAUTOS (Peraccitlent) ' $ / � � � PROPERTVDAMAGE �9 ' (Peraccidenl) $ GARAGE LIABILITY " � AUTOONLY-EAACCI�ENT $ ANYAUTO � � � � OTHERTHAN EAACC $ - ' AUTOONLV: ;AGG 8 E%CESS/IIMeRELLALiABILITY � I I � EACHOCWRRENCE . 5 OCCUR � CLAIMS MADE AGGREGATE ' $ $ DEDUGTIBLE I � � � � - g RET[NTION $ $ WORKERSCONPENSATIONAN� WCl-31S330828—011 �9�28�2�05 ��3�28�200() ORY�AMITS ' �ER �I EMPLOYERS'4ABI4TY ANV PROPRIETOWFARTNEWEXEGUTIVE E.L EAGH ACCIOENT ' $ lOO�OOO OFFICER�MEMdER EXC W DEU? � II yes,tles<ribe under � � � � E.L DISEASE-EA EMPLOVEE$ 100�000 SPECIALPROVISIONSbelow E.I.DISEASE-POLICVLIMIT $ SOO�OOO OTHER / / / / , � � � � � � � � DESCRIPTION OF GFERATIONSILOCATIONSNEHICLESIE%CLUSIONS A�DED BY EN�ORSEMENTISPECIAL PROVISIONS . I � CERTIFICATE HOLDER CANCELLATION � � � � — SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAfION DATE THEREOF, '(HE ISSUING INSURER�WI�L EN�EAVOR TO MNIL ?O DAYS WRITTEN NOTICE TO THE CERTIFIGATE HOL�ER NAMEO TO THE LEFT,BUT C ZTY OF SALEM FAILURE TO DO SD SHALL IMPOSE WO OB4C�ATIO O{t LIA9ILITY OF ANY KIND UPON THE ATTN:BUILDING INSPECTOR INSURER,ITSAGEryZS,QRREPRESENT/RTIV@S.- / CITY HALL AUTHORIZEDREPRESENTA VE! , � � • SALEM MA 01970- � -'"'� ACORD 25(2001/08) .`�� O ACORD CORPORATION 1968 ���.�INS025�Ot08).OS ELECTRONICLASEPFORMS,INC.-(800)327-0545 �� � Pageiot2 � . �Tlrt conunonwealtlir ojMnssachusdb Deparh�tnt ojlndasMd Atcldada ����� 600 Was6te�Slhref Bosto�MA 02111 ww�.�as�✓dIi Worken'Compenaadon Insurana A�davtt: Boflde�a�Contndors/Eledridsn�/Plambeit A H Inf a . . Pla Name . • n1 _ i?E7T6 ��N% �L c%"c Address: �v d2��L� �! . . Ciry/Statetlia ct�P/� f"/u • Phane� �� .�i z�/� , . Are yo�aa , " _ er!C�tet ve'ippraprlate bon' :, - � . 1.�-I-am s�: , •� � �I am a genaai oontractor ond I ���P������: �e��'.� � �ave naea me�s�o�s D xea oo�u�don empbyea(mu am/a�put��me} ssoea�me amchea�uee�.t �: {�j xemoaet� �.D i�.����� sn;p am um m emptoyea �ae mb-conaacen nave s. p nemout� wbd�5armamaaopteapaaty. aO�Ri'.�P.�aoo� 9• �Bn�d�Baddm°° [Ne�uotke4�aa�y,mwraotx . S. � We ae�cmPp�?a�aod�' � � n9ui[ad.j-� �� .. officai bqyne eu�ieo��ea 10.�Electrical�aus os additio� 3.� I�m a homeowmt.domi�11 wotk right ofeiiAoptiqn pdMCZ;" !1.Q PS�bini re�in �addidonr �[�w���; a ts2,g�(X�aoi�i�e bave�uo 12.p Roof r�a. , msarmoe teqnfro�]t. . �Db1'�L�'Io wo�eri' � . 13.0 O�er �. � ��:r. •Any qipNcet tmt ebeet�bwc p mut�Lo 59 MR41[s�eias bebv imv��ek.�w�a�m�o�Do�Y� ' t NoueoNnes vr1�o�5�t�6�davit adicNq mry a�dom��q�k�d��oohid�ao�e0onriiuk aLnit�nnv�davk�it�mc3. �Cwtraln ht ebaetmbboar�mt do�rLad e�ddiHaod�Leet iho�vm�ffi��s titmraboo�ppn�edfiei w�odom�'eae�PahY iufa�trtioa. r.aqr�ernployorA�rbpro►�lna,vo.kers'eon�pau�Aloabiaw+u�ala�a�pfo�et� ael�.6rRsp�y.�Jo3sla �� ��,�N�:L 3� -- ���ms��.r.�.n:�vci- �sa���-a�- -o�� E��nm: �� a6 Id►siuAdQcea: � �/,4�� �llC��/ %�rzP��� ' C�y/Sm��,or1 . �ti AitaeY a eop�d 16e�vorkerr'compenutloa poltq declantloe Ya�e(�Mowlst tie polk�aamber aad e�plratloi date} Fulme ao saore oovaa�e n reqimed undu Scction 2SA of MGL a 132 cm lead b tLe imposidon ofcr�mal penalties of s fine up to S 1,500.00 anNo�oao-year�a�weD ar civl pmalaa m the fmm of a STOP WORR ORDER and a 6ne of up to SZ30.00 s dry agamat 9�e violatoc He advibed that a oopy of thu statemeat may be�udad b tLe OtHce of Iavati�aons of the DU►far inaurance ooven�e veri&adon. t b A�aieb� r�4s �nJ a�btet o�1eJone�Now provlJel 6 �nl earecs i D / S db Phone M: ��cY ?�?u �`7/a O,aldd iut a�l�t !!i�wif wrNt!w tlih�rty te bt rnwplet�l6�edr abw�o,dfel�L Clt�or To�n: TermkR.loeou N Issain�Aathork�(drde one): 1.Bard ot Ha1tY 2.HuildlnQ Deputmeot 3.Cky/fow�C1erk 4.Eledrleal Ia:pator !.Plambing Impector 6.Other Coatzet rmon: Phont M• Information and Instructions � .... , :.:. . ... ..: ._:__ ., ,�On�r meie emr�oytp. �(9ema1 Lsva�cLaPac 1S2 raqnaa aII av111�0�p�!'���� �ofLirq . ' . po[euffit b fhis�le. ffi s� �a defiood�"...eiray pasou in�e eavre�f anotM�a a"Y q�or imphad,oial or vnit0ea' , p,n�pfOjur u1 de8ned as"aa mdividoa�,P���'°�°�°����� °i mo�e in i' �������a� Howey t�e oitLe� o�����cr ot6rr]eg,�l eo1aY.emPbY�i�P1oY� q.., teaivaa nn�tea mt mon tba�ra�and wbo raida tLaem.or the o���`' owncr of s dwcllmi hO°s��1oyi P�m b do mamtenaute.o�nstru�°������b0°�� �house oimother ��abaD not beau�of a�ch emPluYmeat b�damed t�be m emPbya� ba an tLe�abm7d'mt� MQ.�154.425G(��stata th�t"eve�ddt or loal tlend�t�i�7�wdt6rald Ht bna�a or raew�al d t Iks�c or Pe��t0°P��bul�m or to�b�0 i�tYe eommo�wnllt t�07 ippuwt wYo W rat Prod�aa�+�aWaea deomPllasa w�NY tYe W�naae eavua�e nQ�» nddidonally,l�3.chaP�is�4����teitha the oommnvra�mr anr otia po�dal mb�v� � eo0a in6��y contc�ct Sot�P�ofpubNc vwd�mti1 acceptablo evidence uf eomPNaou vri�the msoraae rptnaemean Of thi�chaPoe�Lavebas pram6ed b�a oa�Irudoi.adLot4Y•" • - � , . .;, _ . , _. ,. ..__ _ �� . a�ation aod.if Please fiU,oYt the wotketf'comp�s��°OmPk�'•bY��0 b0ua�at�P�b Y'o� � neoeasa�Y.�PP�Y�s)name{al add�st(a)u�P��sa�with tLeir ceRi&aBd�)of in�ur�ce; Limited I.iab�itY ComP�(�°�Limioed Liabi'ht'Y Patooera�(�w;�m���tue �be�oi partnae,are not raNirad b ca�'���ti0°�' If w LLC a L1B doa Lave emPlcYa4 a Po1�Y�r�' Be advisad that thu at6dayR�Y����D�e DeQartmmt ot I�ustrial paidenti S�am�m�of insasauce cova��e. AI�O by wre t°d�ud date t6e amdavk. 'Ihe a�dsvrt slwuid ��d yp�e city or toarn Ihat�e spptiption fa�e pamit ot licenae's beio�ra4oated.ad the D�� SD9o�Y��a�Y 9�����e law or ifyon m reqa'sad to ob�a wrorken' ���� at the�mbet lls9�1kbw. Self-mw:ed oonopamia aL°nid eater tLe�ir conopenestio�Po���'��6 DewR� self in�e��O°� ' a tma qq or Tow�Ofdda4 . � Please be s�ue tbat the s�davit ir oomplcu wd priated le�bty. 1Le Dcpuunent Laa Fz'cvidod a space at the botoom of the af6davit far you�0 6ll out in d►e eveut ihe Of9ce of Imesdgatione haa to contxt Yoa re8a�dm6��PP�� Plcase be siae oo�ia the pamalliceme�a wLich will be used as a refueoce m�mber. In addition.au aPP� iLat mut sabmit�1tiPk Pecm���P�O°�ia a°y�ven yar,aed only submrt one aPgdavit indicatin8 aarent � pp��p/�IOD(lf L��Y����JOb SrtE Ad�/��E 7�11Cffit ShD➢1d WIItO�31110Cat�dM 1R (�Y� oown)"A coPY of4ee a�it t�tbn beaa o��d 9I��b7C!��P a wwn maY be P�wid�to da appHeant a�pmof dut a valid atBdsvit�on 51a fa 6dare pamitt�licema. A oew af�dav��ltbe 911ed au ach yea.Where a home owna or dt(zea i�ob�s Haeme ar pamit not rdued,�o my businw ar o�erc�e�veamre (ia a do;liami�pamit to barn lqva eoc.)aaid Paaon a NOT raloued b comPku t6a a�davit The O�ee of Invati�tnm would 1�7ce oo th�k yoa m advance fa your coopaation and should yoa bave anY 4ue�o�s, please do not haifa�e b�ve as a c�ll: The DePa�e°r�addse�,u�P�aod fxc maiba: The Commonwealth of Massachnsetts Department of Indushiai Accidenb O�a of Inveatt�adoa� 600 Washington Strcet Boston,MA 02111 TeL#617-727-4900 ext 406 or 1-877-MASSAFE Faa#617-727-7749 RcviSod s-26-os qrWqr.mass.gov/dia � � � i i � I ' ' ' ,. . ' ` , �� ;, a �; , �� �� m �� ,� — — — — —� , - • __ -- � � �� ! � � ; Ep� i //- �' . . I . i i ;II i �r I.�1.., :; I\�, ' i i-:l= ' i ' . ' I ,. . ', �'' ` � I i ' — � � i � ��.. 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I . .. __. i __. .. . . _. . i. i i _. .. . . . _ _ � � 9 i � IdELUCATE: DEMO'D DUC� � W'vGRK. CAP FLOOR AND WPTCN ALL SURFACES WFFECTED PA�'LOR � DINING ROOM L IVIIVC=1200M \ � WET BAR � �, � - - - DUC T CI aASE_ u \ � n � 0 2 n� U�EN S c � _ � � � � �S�AfJD � STOVE ANG �L ! �-JOOD — � � � � � � .-� G �� � _ � � � � � � �, � � � — — � . DN � � �, ���� �� � � Q , � N�b';� 'rL,NTkiCS � � � � FO�i Ek _ ��'�� KITGHEN - -- � ISH. I . O l _ ___�-� J I � pQ�T'� - O PANTRY POST4 � r �� � � � n EX FDN. - -- --- --- Z � ��... - - --- Ml�i OLAM � , MICROLA � LAVATORI" � � t — � �^ . — i � s � � �..r— _ _ � _ ! � � - =i „ i�_ � � �� k'L-i1 .. � � �' 13ENC4-I POS I ,_� �_ � —. — _ w��,�ow �� wiDE 3 � � - � wiN�Uw � • � CANOPY ABOVE FIRST F L00�' �� '� � � SCOPE OF WORK� — - — � , ,,i i ,,..,ui�ua:.u...1i. ,a. ,.�,.�u..�u.., , ��IYWk„ ._llila: .. ,. , ..